学术环境中慢性鼻-鼻窦炎伴鼻息肉患者的临床特征。
Clinical Characteristics of Patients with Chronic Rhinosinusitis without Nasal Polyps in an Academic Setting.
机构信息
Division of Allergy and Immunology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Ill.
Division of Allergy and Immunology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Ill; Department of Otolaryngology, Northwestern University Feinberg School of Medicine, Chicago, Ill.
出版信息
J Allergy Clin Immunol Pract. 2019 Mar;7(3):1010-1016. doi: 10.1016/j.jaip.2018.10.014. Epub 2018 Oct 25.
BACKGROUND
Although patients with chronic rhinosinusitis without nasal polyps (CRSsNP) represent a majority of the chronic rhinosinusitis (CRS) population, they have not been completely characterized phenotypically.
OBJECTIVE
To perform a comprehensive phenotypic characterization of subjects with CRSsNP, using CRS with nasal polyps (CRSwNP) as a comparator.
METHODS
Patients with a history of CRS with positive sinus computed tomography (>18 years old) evaluated in the allergy/immunology or otolaryngology clinics of an academic center between 2002 and 2012 were identified via International Classification of Diseases, Ninth Revision codes. A retrospective chart review was performed on a subset of 507 patients with CRSsNP and 874 with CRSwNP. Characteristics analyzed included demographics, comorbid conditions, and radiologic sinus severity.
RESULTS
Of the total CRS population, approximately 82% had CRSsNP and 18% had CRSwNP. Of the 507 patients in the CRSsNP group, 319 (63%) were female compared with 393 of 847 (45%) in the CRSwNP group. The prevalence of atopy was 52% in CRSsNP versus 76% in CRSwNP (P < .0001). In CRSsNP, atopic patients had more severe radiographic disease compared with nonatopic patients (P < .005). The prevalence of asthma was 36% in CRSsNP versus 56% in CRSwNP (P < .0001). Comorbid asthma was not associated with radiographic sinus disease severity in CRSsNP but was associated with severity in CRSwNP (P < .0001).
CONCLUSIONS
The relative prevalence of CRS phenotypes in the western population is approximately 80% CRSsNP and 20% CRSwNP. Patients with CRSsNP were predominantly female, whereas patients with CRSwNP were predominantly male. The prevalence of asthma was higher in our cohort of patients with CRSsNP than previously described. Atopy was associated with more severe radiographic sinonasal disease in CRSsNP, whereas asthma was not associated with radiographic sinonasal disease severity.
背景
虽然慢性鼻-鼻窦炎伴鼻息肉（CRSwNP）患者在慢性鼻-鼻窦炎（CRS）患者中占大多数，但他们尚未在表型上得到完全的描述。
目的
通过与伴有鼻息肉的慢性鼻-鼻窦炎（CRSwNP）进行比较，对 CRSsNP 患者进行全面的表型特征分析。
方法
通过国际疾病分类第 9 版代码，在 2002 年至 2012 年期间，在学术中心的过敏/免疫学或耳鼻喉科诊所评估的有 CRS 病史且鼻窦计算机断层扫描阳性（年龄大于 18 岁）的患者被确定为研究对象。对一组 507 例 CRSsNP 和 874 例 CRSwNP 患者进行了回顾性图表审查。分析的特征包括人口统计学特征、合并症和放射学鼻窦严重程度。
结果
在 CRS 患者中，约 82%为 CRSsNP，18%为 CRSwNP。在 507 例 CRSsNP 患者中，319 例（63%）为女性，而在 847 例 CRSwNP 患者中，393 例（45%）为女性。在 CRSsNP 中，特应性患者的放射学疾病严重程度高于非特应性患者（P <.0001）。在 CRSsNP 中，特应性患者的放射学疾病严重程度高于非特应性患者（P <.0001）。在 CRSsNP 中，特应性患者的放射学疾病严重程度高于非特应性患者（P <.0001）。哮喘的患病率在 CRSsNP 中为 36%，在 CRSwNP 中为 56%（P <.0001）。在 CRSsNP 中，合并哮喘与放射学鼻窦疾病严重程度无关，但与 CRSwNP 中放射学鼻窦疾病严重程度有关（P <.0001）。
结论
在西方人群中，CRS 表型的相对患病率约为 80%为 CRSsNP，20%为 CRSwNP。CRSsNP 患者主要为女性，而 CRSwNP 患者主要为男性。与以前描述的相比，我们的 CRSsNP 患者队列中哮喘的患病率更高。特应性与 CRSsNP 中更严重的放射学鼻-鼻窦疾病有关，而哮喘与放射学鼻-鼻窦疾病严重程度无关。
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